Diverticulosis
Diverticulosis
21 Self-Care Techniques
Once upon a time—say before 1900—diverticulosis was just another of the many "rare" medical conditions doctors had heard about but seldom seen. And in Third World nations, diverticulosis is rare even today.
But not in the United States, where people can easily live on a diet of processed foods.
"Diverticulosis is a problem that is acquired," says Paul Williamson, M.D., a general and colon and rectal surgeon at Orlando Regional Medical Center in Florida. "It's come about with the advance of processed foods—foods that are low in fiber." (Fiber is important because it helps reduce tension on the colon and helps it expand when eliminating waste.)
A lot has changed since 1900. Studies now indicate that more than half of those over the age of 60 have diverticulosis—which is characterized by tiny, grapelike pouches or sacs (diverticula) along the outer wall of the colon.
These pouches show up on x-rays, but many people never have this area x-rayed and don't even know that they have diverticulosis, says Samuel Klein, M.D., an assistant professor of gastroenterology and human nutrition at the University of Texas Medical School at Galveston.
Of those who do have diverticulosis, Dr. Klein says, only about 10 percent will ever get diverticulitis—a painful inflammation that can become serious. So having diverticulosis does not mean you are destined for severe pain and a hospital stay.
And fortunately, you can take an active role in treating and preventing diverticulosis. Here's what our experts suggest.
Putting More Fiber into Your Diet You know that getting enough fiber in your diet (30 to 35 grams daily) is the most important thing you can do to treat and prevent diverticulosis. But what you may not know is how much fiber is in the recommended high-fiber foods, or, how to inject more fiber into your diet without sitting down to a bowl of raw bran. Here are some tips for making the transition to a high-fiber diet. - Make a habit of eating whole-grain bread instead of white bread.
- Answer your sweet tooth with fruit desserts—berries, bananas, peaches.
- Eat more vegetarian meals.
- Leave the skins on apples, peaches, and pears when you bake them.
- Add dried fruits, such as raisins and apricots, to your meals.
- Substitute beans for beef in chili or casseroles.
- Add barley to vegetable soups.
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Bulk up on fiber. The average American gets about 16 grams of fiber daily, or only half of what he should be getting, says Marvin Schuster, M.D., chief of the Department of Digestive Diseases at Francis Scott Key Medical Center in Baltimore, Maryland. "Bran fiber appears to be the most effective," he says.
Fiber draws water into the stool, making movements smoother. Whole wheat bread and all-bran cereals are excellent sources of bran. Sprinkling raw bran over foods is also an option.
Vegetables and fruit are other good sources of fiber, adds Dr. Klein. "If it's fiber you're after, eat an apple instead of drinking apple juice. The juice typically doesn't have any fiber."
Increase your fiber intake slowly. "Do this gradually over six to eight weeks," Dr. Klein suggests. "You need time for your digestive system to adapt."
You can expect bloating and gas the first few weeks, Dr. Schuster says. "But most people will get over this."
If you can't get enough fiber in your diet, take a supplement. "Take psyllium seed supplements (such as Metamucil), says Dr. Schuster. "They're natural, too."
Drink a lot of liquids. "Drink six to eight glasses of water a day," advises Dr. Klein, adding that the liquid is an important partner to fiber in combating constipation, which is associated with diverticulosis.
"If you have to strain a great deal when having a bowel movement," Dr. Schuster says, "you tend to expand those little diverticula through the muscle walls of the colon."
Go when you have to go. If you don't yield to nature's call, you defeat the purpose of adding more fiber to your diet and drinking more liquids. "Don't suppress the need to move your bowel," Dr. Williamson advises.
MEDICAL ALERT
From the Benign to the Serious If you live long enough, chances are you will get diverticulosis. Even so, odds are you won't get diverticulitis—painful inflammation that is potentially serious. Still, you should be aware of the warning signs. Fever and severe pain in the lower left portion of the abdominal region are good indicators that diverticulosis has advanced to diverticulitis, says Marvin Schuster, M.D. This change shouldn't be taken lightly. "You can have rupturing or bleeding," says Albert J. Lauro, M.D. And while it doesn't happen often, people can die from diverticulitis. So act on those warning signs and get to a doctor fast. And stay calm—the odds are still in your favor. "If it's just an infection," Dr. Lauro says, "it usually can be handled with rest, diet, and antibiotics. You'll be okay." |
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Exercise. It tones more than your legs and hips. Exercise also tones the muscles in your colon. "It helps bowel movements; you don't have to strain as much," says Dr. Klein.
Don't use suppositories. While they may offer a quick fix to constipation, they aren't the best choice for stimulating bowel movements.
"Your system can get addicted to it," Dr. Klein explains. "And then it becomes a vicious circle—you need more suppositories."
Go natural. "Prunes, prune juice, and herbal teas are very effective natural laxatives," Dr. Schuster says. Specifically formulated teas can be found in most health food stores.
Don't smoke. Harmful in so many ways, smoking also may aggravate diverticulosis, says Albert J. Lauro, M.D., director of emergency medical services at Charity Hospital in New Orleans, Louisiana.
Eat highly processed foods only in moderation. This is good general health advice, but also applies to treating diverticulosis. If you eat a lot of low-fiber processed foods, says Dr. Klein, you won't have room to eat the high-fiber foods you need.
Chew seeds extra well. Foods such as nuts and popcorn contain seeds or other hard particles that could become lodged in the diverticula and cause inflammation, Dr. Klein says.
"And if you've ever had an acute attack of diverticulitis," Dr. Lauro adds, "you should keep away from foods that have seeds."
Drink only in moderation. "Alcohol in moderation—a drink or two a day—will actually relax spasm of the colon and could improve the situation a little bit," says Dr. Schuster.
Avoid caffeine. "Coffee, chocolate, teas, colas—all tend to irritate," Dr. Williamson says.
Look for a pattern. Certain foods may disrupt your bowel habits or cause loose stools, Dr. Williamson says. Try to identify those foods and avoid them.
PANEL OF ADVISERS
Samuel Klein, M.D., is an assistant professor of gastroenterology and human nutrition at the University of Texas Medical School at Galveston. He is also an editorial adviser to Prevention magazine.
Albert J. Lauro, M.D., is director of emergency medical services at Charity Hospital in New Orleans, Louisiana.
Marvin Schuster, M.D., is chief of the Department of Digestive Diseases at Francis Scott Key Medical Center in Baltimore, Maryland, and professor of medicine and psychiatry at Johns Hopkins University School of Medicine in Baltimore.
Paul Williamson, M.D., is a general surgeon and colon and rectal surgeon at Orlando Regional Medical Center in Florida.
